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The fallacy of age as a predictor of future Digital Health adoption

Today's older adults will not get a 'check engine light for their body.' Investors in innovation worry when utilization of technology doesn't match hyper-hysterical investment pace.  So it is with Digital Health. Buried beneath broad and unclear definitions, how about that 'check engine light' metaphor -- reset it yourself, go ahead! Vague and hyper-funded, Digital Health, says Startup Health, received up to $5 billion investment just in 2014. Still there's bit of whining about startups starting but users not adopting. So what's the solution?  Don't critique investment decisions, bad product ideas and those dual dilemmas of doctor and patient disinterest.  See VC Tom Rodgers push the predicted adoption date out another 15-20 years and at the same time criticize the non-tech literacy of the old and sick of today. Says he: Digital Health will go mainstream when millennials are older and sicker.

So why bypass older adult segments to wait for millennials? Mr. Rodgers has guts. Might tech innovators who heard him speak actually shudder as they saw their near-term dreams of post-IPO riches fade? Millennials are the youthful folk aged 18-33 -- apparently their older and sicker future is when they will be between 38 and 53. Rodgers waves away all of those pesky issues of data privacy and security and notes that doctors are key to adoption -- but the real key is that "millennials who grew up with technology will need to start getting sick." Nice. Actually, it would appear that millennials are fairly sick now and may have an even bleaker health future, since so many of them spend much time alone in front of screens, are completely stressed out, and unlike boomers, are apparently not okay with waiting two weeks for an appointment

Real boomers and seniors fill the doctors' offices today. Maybe Digital Health strategists should think a bit more about them. Unlike those millennials, boomers and seniors are generally aware of their chronic diseases or acute health issues that forced them to visit the doctor. There is really nothing much for them to use at home other than a thermometer or an online symptom checker, though thankfully, there's that patient portal for them to get appointment reminders and find the results of tests. Yet the doctors who Rodgers says are "key to adoption" are a worried group, rightfully concerned about the job's loss of prestige and imperiled reimbursement rates. As for health IT, uh, I mean Digital Health, doctors are still slogging through EHR implementations that have made their jobs miserable and forced them to look away from the patient at screen after screen of maybe-useful-maybe-not history -- concerned that today's EHR is turning them into data entry clerks.

Health systems like Epic are appropriately named.  Implementations are outrageously expensive -- $4 billion for Kaiser Permanente!  Soon 51% of people in the United States (via CVSCaremark) will have Epic data records. In the world of patient portals, big data, and growing angst, if middle-aged millennials will be using devices to self-monitor their own vital signs, will all be better for the doctor-patient relationship? Will they note the Millennials' ability to perform activities of daily living, keep up their walking pace or note their loss of ability to remember names? All of the geriatricians and even training about geriatrics will be gone by the time any millennials would stand to benefit. By then, millennial patients will be so wacky from false signals from their check engine lights, that doctors will be begging them via video to stay home, take two aspirin and Skype in the morning.  And investors will be be relieved. Digital Health, now deployed in Epic proportions, will be fully adopted.

Comments

Since we’re building a watch that our focus groups call a “wearable OnStar for seniors”, I am very familiar with hearing VCs opine that next-generation seniors will be more tech-friendly, and we should target our solutions there. In our business’ case, this type of VC’s feedback is all about how the Boomers will be happily using their smart phones well into their 80s, so pairing with a smart watch with small touch screens and buttons will be no problem, and aging-in-place support is as easy as an iPhone/Android app.

When I hear this, I know I’m talking to the wrong VC because:

• They’re ignoring today’s 17M aging-in-place 75+ seniors who need viable solutions, 15M of whom are unserved by the traditional PERS (personal emergency response system) market.

• They don’t have the empathy to understand that aging-related changes don’t care how much of a techie you were in your youth - and even into your early 70s. Degradation in vision, muscular control (tremors and arthritis), and cognition bound the user experience for older adults. So in 2030, when we have a projected 27M aging-in-place 75+ seniors that includes much of the Boomers, I don’t see Boomers’ previous tech literacy changing the user experience requirements at all. (I do see Boomers being on-line in 2030, just as today’s 75+ market is - but I expect the online experience to be tablet-based in 2030, just as it is today - and for the same reasons.)

Maybe what we need to have technology make a difference for our rapidly-growing aging population is more access to funding from empathic sources who can do a better job of comprehending an older adult’s real challenges. I don’t believe that adoption is poor because older adults are disinterested; I think adoption is poor because we’re funding the wrong solutions.

I think that you and Laurie have duly exposed a flaw in today's thinking about current seniors. Recent elections don't bode well for seniors.

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